Bellyaches in Kids (and the "Und Here" Syndrome)

July 9, 2014 Uma Pisharody, MD, FAAP

Bellyaches, stomachaches, or belly pain in school-age children are a common occurrence.  At least half of the children that get referred to pediatric gastroenterologists like me come for treatment of their chronic, recurrent abdominal pain.  Parents often feel frustrated because despite multiple visits to physicians, even emergency rooms, they are left with more questions than answers all whilst their child continues to suffer.

A typical scenario is a child whose pain seems worst in the mornings after awakening and towards the evening, especially after dinner or before bedtime.  Often the child doesn’t want to eat breakfast and if forced, tells his parents he feels nauseated.   When asked where the pain is, the child most often points to the area around his belly button.

More often than not, depending on a few other factors, the diagnosis ends up being functional abdominal pain (FAP), a type of pain that stems not from disease per se, but as I like to call it, “sensitive nerves” in a child’s abdomen.   Unfortunately, some kids with FAP suffer with more than just abdominal pain. They have what is known as functional abdominal pain syndrome, where they may also experience generalized body aches and pains, leading them to miss school and participation in other normal childhood activities.   In German, this syndrome has a very illustrative name:  “Und here”.  Germans jokingly give it this term because when asked to show where it hurts, a patient may point to one spot on their abdomen….and then move their finger saying, “und here” (pointing to another spot)…..“und here” (showing another area)….and so on and so forth.

When trained pediatric gastroenterologists like me see kids with bellyaches or “stomachaches”, there are a few key questions that we know to ask to make sure no underlying disease is being missed.  We also make sure a thorough exam is performed, and sometimes we’ll even order a few tests to make sure our hunch about FAP is correct (in which case, the test results will be normal).  Sometimes, it can be hard to differentiate FAP from a disease, which is why parents should always discuss their child’s pain with a doctor. 

When a child has FAP, even though there may not be an underlying “disease” to “cure”, there are many ways to help the child feel better.   The team at Swedish Pediatric Gastroenterology wishes no child ever had to suffer with any pain, but should your child need help to decrease their pain and suffering, we are here to offer our expertise and help.

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